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SFscruff

I was in a six month PK (pharmacokinetics) study of Lyrica/pregabalin this past winter and spring. I titrated off Neurontin/gabapentin, endured a 'wash-out' period, was administered the Lyrica/pregabalin or placebo under supervision, and blood was drawn at specific intervals to check the amount of Lyrica or placebo in my bloodstream. I recorded pain scores for my small-fiber lower leg and feet neuropathy on an electronic pain dairy that continued when Lyrica or placebo was added to my home formulary. The study was double-blinded until two months ago, when I was notified that I had indeed been administered Lyrica/pregabalin at 75mg, at 12 hour intervals.

My personal experience was that there was no difference between Lyrica and Neurontin on various subjective pain measurement and objective nerve conductivity scores. Pregabalin is a 2nd generation analog of gabapentin, nearly identical to gabapentin, and apparently developed by Pfizer to retain market share when Neurontin/gabapentin comes off patent protection. There are only three inconsequential 'points' in the analog difference between the two medications and double-blind, placebo-controlled studies comparing Neurontin and Lyrica are statistically identical in outcome for peripheral neuropathy pain coverage in HIV patients. I guess 'lyrical' Lyrica sounds more 'dramatic opening score' than 'tinny' Neurontin.

The only difference, other than a huge price, appears to be that Neurontin is more dose-dependent than Lyrica, so for patients with compliance issues, Lyrica might be easier to take. Increasing the milligrams in each dose of Neurontin supposedly is largely ineffective as 'the more you take at once, the less gets into your bloodstream.' Apparently, the gut receptors can only absorb and transmit a certain quantity of the Neurontin and the rest is excreted in the feces. I switched back to 600mg of Neurontin at eight hour intervals for lower peaks, higher troughs and adequate coverage. All I can say for Lyrica, is that the study paid a couple hundred dollars and I got some pretty snazzy measurements and tests performed and added to my medical chart. SFscruff

I also take Lyrica. They just ^ it to 150mg2xaday. I don't feel a difference. I don't have stabbing pains threw my ankles,but the pain is still there very bad. It hurts so bad I actually feel like cutting my legs off. Now it is starting in my hands and arms.Don't know what to do about it anymore,I was on morphine patch but had a reaction.I'm affraid to start taking pain meds,so I just suffer with it.

I also take Lyrica. They just ^ it to 150mg2xaday. I don't feel a difference. I don't have stabbing pains threw my ankles,but the pain is still there very bad. It hurts so bad I actually feel like cutting my legs off. Now it is starting in my hands and arms.Don't know what to do about it anymore,I was on morphine patch but had a reaction.I'm affraid to start taking pain meds,so I just suffer with it.

Hi JNT,

Sorry to hear about your neuropathy problems. I read your other post about the diabetes and it sounds like you are having some problems controlling your blood sugars (A1c at 10). The neuropathy is probably related more to this than the HIV and would not likely improve unless your blood sugar control improves. Hopefully, you and your diabetes doc can find a way to get this under control. Good luck.

G

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SFscruff

dgls44, I'm no doctor, but from what I've read and been told by neurologists, etc., the 800 mg in a single dose of Nurontin/gabapentin would most likely be poorly absorbed. Neurontin is very dose dependent, it supposedly varies by individual, but smaller does more often is recommended for better pain type coverage and fewer of the 'zonk+dizzy+walk-out-in-traffic+gooey' side effects. The problem is taking the spread-out doses when they don't necessarily correspond to dosing times for other medications. Always a trade-off. I tried the various complementary supplements, but found that the benefit was rather, humm, abstract. Since pain is so subjective, it did feel better when taking them, because I knew I was doing something, but they are quite pricey. I just ended up spending the money I was budgeting for the supplements on higher quality food ingredients. I also massage my lower legs with essential oil of peppermint, it feels great, like a gust of cool wind from a mountain glacier, right. A friend also gave me one of those U.F.O. looking foot spas, it feels great too and lets me multi-task (reading!). Mindfulness meditation also helps change the focus and understanding of the 'innocuous' and idiopathic pain from peripheral neuropathy, again, something of a placebo, but helpful. SFscruff.

I had the unfortunate luck to get Shingles. . I went to my Family Practice physician and he gave me lyrica. It worked for me. The standard dose did not work so the doc upped the dose. As the shingles went away, I was finally able to get off the medication. The doc had just started using it in his practice for shingles and said that I was his 5th success with the medication for the neuropathy.

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SFscruff

AustinPZ, Neurontin/gabapentin has been prescribed for years for relief from post-herpetic neuralgia, there's quite a bit of literature and clinical experience in minimizing the pain from varicella zoster in HIV patients. Odd that your doctor hasn't been prescribing Neurontin for neurological conditions and is now on the Lyrica bandwagon. Scruff